Prevalence of Chronic Kidney Disease in Patients with Diabetes in Extremadura (Spain) during the Years 2012, 2013 and 2014: An Observational Study.

Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD). We analyzed the prevalence of CKD in the population with diabetes in Extremadura (Spain). retrospective observational study was carried in the diabetic population attended in the Extremadura Health System in 2012-2014. A total of 38,253 patients, ≥18 years old were included. Estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration equation. CKD was defined as follow: an eGFR <60 mL/min/1.73 m2 in a time period ≥ of three months or the presence of renal damage, with or without reduced eGFR, if the urine albumin-creatinine ratio (UACR) was ≥30 mg/g, also in a time period ≥ of three months. The prevalence rate of CKD was 25.3% (27.6% in women; 23.0% in men) and increases with age (34.0% in ≥65 years-olds). 24.9% of patients with CKD were in the very-high risk category for cardiovascular events (6.3% of the diabetic population). If CKD were diagnosed without requiring sustained eGFR <60 mL/min/1.73 m2 and/or sustained UACR ≥30 mg/g (as it is frequently found in the literature) this would overestimate the prevalence of CKD by 23%.

Prevalence of diabetes and frequency of glycated haemoglobin monitoring in Extremadura (Spain) during 2012, 2013 and 2014: An observational study.

AIMS: To analyze the prevalence of diabetes and the frequency of haemoglobin A1C (HbA1C) monitoring in the population with diabetes in Extremadura (Spain). METHODS: Observational, longitudinal retrospective study in the population attended in the Extremadura Health System in 2012-2014. A total of 403,644 glycated haemoglobin determinations in 189,466 subjects (52.4% female) were studied. All patients with a prescription of antidiabetic drugs and those who, despite not having treatment, had any determination of HbA1C ≥6.5% were considered as people with diabetes. All patients without treatment but with HbA1C ≥5.7% and <6.5% were considered prediabetes patients. RESULTS: The prevalence rate of diabetes was 8.3% and the frequency of HbA1C monitoring was 0.9/patient/year in the diabetic population. 48.2% of the patients with monitoring of HbA1C had diabetes, 21.2% had prediabetes, and 30.6% did not meet the criteria for diabetes or prediabetes. 12.7% of people with diabetes did not have determinations of HbA1C and only 11.8% have had ≥6 determinations in the period analyzed. CONCLUSIONS: The frequency of HbA1C monitoring in the diabetic population is lower than that usually recommended. Moreover, there is an inadequate use of HbA1C determinations, since one out of every 3 patients does not meet the criteria for diabetes or prediabetes.

Conocimiento de la higiene de manos en estudiantes de enfermería / Knowledge of hand hygiene in nursing students

Las manos de los estudiantes de enfermería pueden ser el vector de la infección nosocomial. La mejora en el conocimiento sobre la higiene de manos (HM) reduce la infección nosocomial. Para ello debemos conocer el grado de adherencia al protocolo de lavado de manos (LM) por parte de los alumnos de enfermería Para ello se pasó un cuestionario estructurado de la OMS para profesionales de salud, antes y después de llevar a cabo un taller formativo. Han participado en el Estudio un total de 63 alumnos de dos cursos de grado en enfermería de la Universidad de Extremadura (UEX), con una predominancia del sector femenino en 76,2 % (48) y 23,8 % (15) para el masculino.Se obtuvo datos muy significativos (p<0,015) en el cuestionario en P9a (0,012), P9b (0,000), P10 (0,000), P11 e (0,005), P11f (0,002). Los estudiantes tienen un conocimiento moderado sobre HM. El estudio muestra la necesidad de seguir mejorando los programas de formación de HM existentes, para hacer frente a las lagunas en los conocimientos y obtener unos enfermeros altamente cualificados en el futuro (AU)

Nursing students’ hands can be the vector of nosocomial infection. Improving knowledge about hand hygiene (HM) reduces nosocomial infection. This is the reason we must know the degree of adherence to hand washing protocol (LM) by nursing students For this purpose, a WHO structured questionnaire for health professionals was done before and after putting a training workshop into practice. A total of 63 students from two nursing degree courses of UEX have participated in the study, with female sector predominance 76.2% (48) and 23.8% (15) for the male. Very significant data were obtained (p <0.015) in the questionnaire P9a (0.012), P9B (0,000) P10 (0,000) P11 and (0.005), P11f (0.002). Students have a moderate knowledge about HM. The study shows the need to improve existing HM training programs, to address gaps in knowledge and to obtain highly qualified nurses in the future (AU)

Inadequate iodine nutrition of pregnant women from Extremadura (Spain).

OBJECTIVE: To evaluate the iodine nutrition of the pregnant women of the Spanish Autonomous Community Extremadura. There are approximately 10,000 births per year in Extremadura, which historically contains areas with endemic goiter (Las Hurdes). DESIGN: Population study in which a representative sample of pregnant women of the general population was analyzed, along with another sample of pregnant women from traditionally goitrogenic areas. With the collaboration of selected health centers, an additional sample of blood and urine was obtained within the primary health care pregnancy-monitoring program; these samples were sent to a single central laboratory. METHODS: Biochemistry: determination of iodine and creatinine in urine, and serum concentrations of thyroxine, free thyroxine, tri-iodothyronine, TSH, thyroglobulin, and two anti-thyroid antibodies. Each parameter was measured by means of a single specific RIA. RESULTS: Changes between the first trimester and later stages of pregnancy of all biochemical variables studied corresponded with those described for other European areas with a comparable iodine nutrition. Using the urinary iodine concentration value as an indicator of iodine ingestion, it was found that in the first trimester of pregnancy six out of ten women from Extremadura ingested less than the currently recommended amount (250 microg I/day), and approximately three out of ten of these women ingested less than half of this amount. CONCLUSIONS: It is imperative to implement in all Extremadura the generalized and controlled use of complements that contain 200-250 microg I/day throughout pregnancy and, if possible, before.